Effectiveness of using automated external defibrillator by trained healthcare professionals on survival outcomes among adult patients after in-hospital cardiac arrest: a systematic review

Introduction: Survival after out-of-hospital cardiac arrest (OHCA) is dependent on early defibrillation. To increase bystander defibrillation in OHCAs, a first-responder program dispatching lay rescuers (Heart Runners) through a smartphone application (Heart Runner-app) was implemented in the Capital Region of Denmark. We investigated the proportion of Heart Runners arriving prior to the Emergency Medical Services (EMS) and rates of bystander defibrillation. Methods: The Capital Region of Denmark comprises 1.8 mil. inhabitants and 19,048 Heart Runners were registered. In cases of suspected OHCA, the Heart Runner-app was activated by the Emergency Medical Dispatch Center. Up to 20 Heart Runners < 1.8 km from the OHCA were dispatched to either start cardiopulmonary resuscitation (CPR) or to retrieve and use a publicly accessible automated external defibrillator (AED). Through an electronic survey, Heart Runners reported if they arrived before EMS and if they applied an AED. OHCAs where at least one Heart Runner arrived before EMS were compared with OHCAs where EMS arrived first. All OHCAs from September 2017 to May 2018, where Heart Runners had been dispatched, were included. Results: Of 399 EMS treated OHCAs, 78% (n=313/399) had a matching survey. A Heart Runner arrived before EMS in 47% (n=147/313) of the cases, and applied an AED in 41% (n=61/147) of these cases. Rate of bystander defibrillation was 2.5-fold higher compared to cases where the EMS arrived first (Table 1). Conclusions: By activation of the Heart Runner-app, Heart Runners arrived prior to EMS in nearly half of all the OHCA cases. Bystander defibrillation rate was significantly higher when Heart Runners arrived prior to EMS.

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Changes in automated external defibrillator use and survival after out-of-hospital cardiac arrest in the Nijmegen area

Netherlands Heart Journal ◽

10.1007/s12471-018-1162-9 ◽

2018 ◽

Vol 26 (12) ◽

pp. 600-605 ◽

Cited By ~ 9

Author(s):

J. Nas ◽

J. Thannhauser ◽

J. J. Herrmann ◽

K. van der Wulp ◽

P. M. van Grunsven ◽

...

Keyword(s):

Cardiac Arrest ◽

Automated External Defibrillator ◽

Hospital Cardiac Arrest ◽

External Defibrillator

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What Do Adolescents Learn from a 50 Minute Cardiopulmonary Resuscitation/Automated External Defibrillator Education in a Rural Area: A Pre-Post Design

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16061053 ◽

2019 ◽

Vol 16 (6) ◽

pp. 1053

Author(s):

Ming-Fen Tsai ◽

Li-Hsiang Wang ◽

Ming-Shyan Lin ◽

Mei-Yen Chen

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Education Program ◽

Individual Performance ◽

Automated External Defibrillator ◽

Quasi Experimental ◽

Rescue Time ◽

The Impact ◽

Hospital Cardiac Arrest ◽

External Defibrillator

Background: Literature indicates that patients who receive cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) from bystanders have a greater chance of surviving out-of-hospital cardiac arrest (OHCA). A few evaluative studies involving CPR/AED education programs for rural adolescents have been initiated. This study aimed to examine the impact of a 50 min education program that combined CPR with AED training in two rural campuses. Methods: A quasi-experimental pre-post design was used. The 50 min CPR/AED training and individual performance using a Resusci Anne manikin was implemented with seventh grade students between August and December 2018. Results: A total of 336 participants were included in this study. The findings indicated that the 50 min CPR/AED education program significantly improved participant knowledge of emergency responses (p < 0.001), correct actions at home (p < 0.01) and outside (p < 0.001) during an emergency, and willingness to perform CPR if necessary (p < 0.001). Many participants described that “I felt more confident to perform CPR/AED,” and that “It reduces my anxiety and saves the valuable rescue time.” Conclusions: The brief education program significantly improved the immediate knowledge of cardiac emergency in participants and empowered them to act as first responders when they witnessed someone experiencing a cardiac arrest. Further studies should consider the study design and explore the effectiveness of such brief programs.

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How to use an automated external defibrillator following out-of-hospital cardiac arrest

Nursing Standard ◽

10.7748/ns.2017.e10784 ◽

2017 ◽

Vol 31 (32) ◽

pp. 38-43

Author(s):

Elizabeth Simpson

Keyword(s):

Cardiac Arrest ◽

Automated External Defibrillator ◽

Hospital Cardiac Arrest ◽

External Defibrillator

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Neighborhood characteristics, bystander automated external defibrillator use, and patient outcomes in public out-of-hospital cardiac arrest

Resuscitation ◽

10.1016/j.resuscitation.2018.02.021 ◽

2018 ◽

Vol 126 ◽

pp. 72-79 ◽

Cited By ~ 10

Author(s):

Lars W. Andersen ◽

Mathias J. Holmberg ◽

Asger Granfeldt ◽

Bo Løfgren ◽

Kimberly Vellano ◽

...

Keyword(s):

Cardiac Arrest ◽

Patient Outcomes ◽

Automated External Defibrillator ◽

Neighborhood Characteristics ◽

Hospital Cardiac Arrest ◽

External Defibrillator

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The Influence of COVID-19 on Out-Hospital Cardiac Arrest Survival Outcomes: An Updated Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10235573 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5573

Author(s):

Karol Bielski ◽

Agnieszka Szarpak ◽

Miłosz Jaroslaw Jaguszewski ◽

Tomasz Kopiec ◽

Jacek Smereka ◽

...

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

Hospital Discharge ◽

Meta Analysis ◽

Cerebral Performance Category ◽

Spontaneous Circulation ◽

Survival Outcomes ◽

Cochrane Central Register ◽

Mortality And Morbidity ◽

Hospital Cardiac Arrest

Cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest (OHCA) is associated with poor prognosis. Because the COVID-19 pandemic may have impacted mortality and morbidity, both on an individual level and the health care system as a whole, our purpose was to determine rates of OHCA survival since the onset of the SARS-CoV2 pandemic. We conducted a systematic review and meta-analysis to evaluate the influence of COVID-19 on OHCA survival outcomes according to the PRISMA guidelines. We searched the literature using PubMed, Scopus, Web of Science and Cochrane Central Register for Controlled Trials databases from inception to September 2021 and identified 1775 potentially relevant studies, of which thirty-one articles totaling 88,188 patients were included in this meta-analysis. Prehospital return of spontaneous circulation (ROSC) in pre-COVID-19 and COVID-19 periods was 12.3% vs. 8.9%, respectively (OR = 1.40; 95%CI: 1.06–1.87; p < 0.001). Survival to hospital discharge in pre- vs. intra-COVID-19 periods was 11.5% vs. 8.2% (OR = 1.57; 95%CI: 1.37–1.79; p < 0.001). A similar dependency was observed in the case of survival to hospital discharge with the Cerebral Performance Category (CPC) 1–2 (6.7% vs. 4.0%; OR = 1.71; 95%CI: 1.35–2.15; p < 0.001), as well as in the 30-day survival rate (9.2% vs. 6.4%; OR = 1.63; 95%CI: 1.13–2.36; p = 0.009). In conclusion, prognosis of OHCA is usually poor and even worse during COVID-19.

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